While patients and families are at the center of care and have important perspectives about what they see occurring surrounding their healthcare, organizations do not routinely collect such perspectives from patients/families. The goal of our two phase study is to learn how parents of NICU infants can provide insight about patient safety issues in the NICU environment, specifically focused on safety culture. We will use an exploratory sequential two-phased mixed methods approach to address this gap. Phase I incorporates a qualitative approach exploring the experience and perspectives of parents about safety aspects in the NICU. These findings will inform the development of a survey instrument, Parent-Centered Safety Culture Tool (PCSCT), grounded in the experiences of the target population to be developed in phase 2. For each phase, we have one specific aim, which are: Aim 1: To determine how parents conceptualize: (1) various aspects of culture, such as patient safety, communication and teamwork, in the NICU, (1a) their role as patient safety advocates, and (1b) their relationship with caregivers in contributing to patient safety efforts within the NICU. Aim 2: To develop and psychometrically test a survey to measure parent perceptions of safety culture in the NICU. By achieving our first aim, we will understand which aspects of culture parents understand and about which they can provide valuable information. Achieving our second aim will allow us to provide evidence for the reliability, content validity, and construt validity of the survey we will create. Our aims need to be met because surveys must have evidence for these types of reliability and validity in order for future survey users to have confidence in the quality of data collected from them. Once completed, our study will provide valuable information about: (1) what parents understand about safety, (2) what roles they are willing to assume as partners in the NICU to improve the culture of patient safety, and (3) parental perceptions of the safety culture of a NICU. Our research team has substantial expertise in measuring safety culture in general and in the NICU, creating new surveys to measure additional aspects of organizational culture, and engaging patients in understanding their perspectives about healthcare and patient safety. The project we propose is a natural confluence of the mutual interests among the investigators and builds on our existing collaborative research agenda.